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General NPI Number Information
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NPI Number | 1457663593
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Entity Type | Individual
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Provider Name | MICHAEL DAVID SONTAG PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1821 REES ST
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City | BREAUX BRIDGE
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State | LA
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Zip | 70517-4209
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Country | US
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Telephone | 337-442-6959
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Fax |
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Provider Business Mailing Address
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Address Line | 5959 S SHERWOOD FOREST BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-6038
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Country | US
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Telephone | 337-442-6959
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Fax | 225-765-9196
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.200421
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License Number State | LA
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